upstate medical university - new york state comptroller · form b osc use only: reporting code:...
TRANSCRIPT
![Page 1: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/1.jpg)
Upstate MedicalUniversity
3320211
![Page 2: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/2.jpg)
XXXX3320211
![Page 3: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/3.jpg)
XXXX3320211
![Page 4: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/4.jpg)
XXXX3320211
![Page 5: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/5.jpg)
XXXX3320211
![Page 6: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/6.jpg)
![Page 7: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/7.jpg)
![Page 8: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/8.jpg)
![Page 9: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/9.jpg)
XXXX3320211
![Page 10: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/10.jpg)
XXX3320211
![Page 11: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/11.jpg)
XXXX3320211
![Page 12: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/12.jpg)
XXXX3320211
![Page 13: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/13.jpg)
XXXX3320211
![Page 14: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/14.jpg)
XXXX3320211
![Page 15: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/15.jpg)
XXXX3320211
![Page 16: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/16.jpg)
XXXX
![Page 17: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/17.jpg)
XXXX3320211
![Page 18: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/18.jpg)
XXXX3320211
![Page 19: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/19.jpg)
XXXX3320211
![Page 20: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/20.jpg)
SNY01XXXX
3320211
![Page 21: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/21.jpg)
XXXX3320211
![Page 22: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/22.jpg)
![Page 23: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/23.jpg)
XXXX3320211
![Page 24: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/24.jpg)
EXHIBITY
FORMB
OSC Use Only: _Reporting Code: _Category Code:
State Consultant Services
Contractor's Annual Employment Report
Report Period: April 1, _2015__ to March 31, _2016 __
Business Unit State of NY I Department Name I Uostate Medical University I Department ID#: I 3320211Contract No: C-503817
Contract Term: I 10/1/2015 to 9130/2020
Contractor Name: CPS Recruitment
Contractor Address: 904 7th North StreetLiveroooL NY 13088
Description of Services I TemQorary StaffingBeing Provided
Scope of Contract (Choose one that best Fits)
Analysis o Evaluation o Research o Training oData Processing 0Engineering 0 Architect Services 0 Surveying
Other IT Consulting 0o Environmental Services o
Computer Programming 0
Accounting oo
Auditing 0Mental Health Services oHealth Services
Paralegal o Legal o Other Consulting x
Employment Category Number of Number of Amount PayableEmployees Hours Worked Under the Contract
Calculation Clerk I 2 889.25 12,453.35Cleaner 9 4,384.50 57,102.90Clerk 1 3 3,110.75 39,656.55Clerk 2 1 1,870.50 24,890.02Driver 3 1,832.25 24,348.72
Hospital Patient Services Clerk 42 42,349.50 592,752.09Keyboard Specialist 1 4 3,534.75 45,837.93Keyboard Specialist 2 2 1,582.50 21,829.16
Medical Office Assistant 7 5,930.25 99,095.24Motor Vehicle Operator 5 3,147 42,570.36
Patient Transport 3 2,538.25 31,296.92
Total This Page 71,169.50 991,833.24Grand Total
Name of Person who Prep red This Report:Preparer's Signature:
Phone #: 315-883-5481Title: System SpecialistDate Prepared: 5/11116 _Use additional pages if necessary Page _1_ of _2_
![Page 25: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/25.jpg)
FORMB
OSC Use Only: _Reporting Code: _Cate 0 Code:
EXHffiITY
State Consultant Services
Contractor's Annual Employment Report
Report Period: April 1, _2013__ to March 31, _2014 __
Business Unit State of NY I Department Name I Uostate Medical University I Department ID#: I 3320211Contract No: C-503817
Contract Term: I 10/1/2015 to 9130/2020
Contractor Name: CPS Recruitment
Contractor Address: 904 7th North StreetLiveroooi. NY 13088 -
Description of Services I TemQorary StaffingBeing Provided
Scope of Contract (Choose one that best Fits)
Analysis o Evaluation o Research o Training oData Processing DEngineering 0 Architect Services 0 Surveying
Other IT Consulting Do Environmental Services
oo
Computer Programming D
Health Services D Mental Health Services
Accounting D Auditing o Paralegal D Legal o Other Consulting x
Employment Category Number of Number of Amount PayableEmployees Hours Worked Under the Contract
Secretary 1 6 4,970.75 78,504.34Sterile Supply Tech 1 229.75 2,791.46
Stores Clerk 1 16 13,107.25 164,269.75Supply Assistant 16 12,665.50 157,664.30
Total This Page 30,973.25 403,229.85Grand Total 102,142.75 1,395,063.09
Name of Person who Pre ared This Report: ,....JenniferSilverioPreparer's Signature:
Title: System SpecialistDate Prepared: 5/11/16 _Use additional pages if necessary
Phone #: 315-883-5481
Page _2_ of _2_
![Page 26: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/26.jpg)
![Page 27: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/27.jpg)
SNY01XXXX
3320211
![Page 28: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/28.jpg)
SNY01XXXX
3320211
![Page 29: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/29.jpg)
SNY01XXXX
3320211
![Page 30: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/30.jpg)
SNY01XXXX3320211
![Page 31: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/31.jpg)
SNY01XXXX
3320211
![Page 32: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/32.jpg)
![Page 33: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/33.jpg)
SNY01XXXX
3320211
![Page 34: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/34.jpg)
XXXX3320211
![Page 35: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/35.jpg)
XXXXXXSNY01
![Page 36: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/36.jpg)
![Page 37: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/37.jpg)
OSC Use Only: _Reporting Code: _Catego Code:
EXHIBlTY
FORt\1 B
State Consultant Services
Contractor's Annual Employment Report
Report Period: April 1, ~ to March 31, 1\0
Business Unit U state Medical Universit 3320211Contract No:
Contract Term:
Contractor Name:
Contractor Address:
Description of ServicesBein Provided
Scope of Contract (Choose one that best Fits)
Analysis 0 Evaluation 0 Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT Consulting 0Engineering D Architect Services 0 Surveying 0 Environmental Services 0Health Services tZI Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0
Employment Category Number of Number of Amount Payable .Employees Hours Worked Under the Contract
Total This Pal!cGrand Total (') ?). (J
Name of Person who Prepareq This Report: lJj 6'100"\ --::r0 ~ SPreparer's Signature: \.J._).,_,LV) clu. j:+-G-~=------------------------Title: Q\I\.2~ ~ bJ- Phone#: 6'6~- ;?(os:--\ -y~DDate Prepared: '=-\ ~ ~\c-\ \0Use additional pages if necessary Page _\_ of \
![Page 38: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/38.jpg)
XXXXXX C600844 XXXX3320211
![Page 39: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/39.jpg)
FORMB OSC Use Only:Reporting Code:
CateQorv Code:
State Consultant ServicesContractor's Annual Employment Report
Re ortPeriod:A ril1,2015 to March 31,ZD10
Contracting State Agency Name:'5fa-le LJ,1'V(I'"S!.J-i o{ Agency Code:. tVfw uod(_Contract Number: Q_1\,)00'101 4- c.fY)oo'158 -,
Contract Term: ifll 12015 to 31311.J.bl/.bContractor Name: D(:'(dons US LL-P . ,_ .Contractor Address:23_3 5cc+11~vc.dU"r'1).--iv-(',Ch\('(~30'TL loO~')OlO-'~30(oDescription of Services Being Proviaed:
l-e~\ 5erv,'c_t>5- l+E'(~I+I"\Ct)re ,Ye,sulo-\-on·.-'i cp-,cl Con"-?\)c---\Y)ce
Use additional pages if necessary) Page of
Scope of Contract (Choose one that best fits):Analysis 0 Evaluation 0 Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0
Legal¢'Accounting 0 Auditing 0 Paralegal 0 Other Consulting 0
Employment Category Number of Employees Number of Hours Worked Amount Payable Underthe Contract
/ rarine, 15 7"1. ~o 11 159 10&-9.00Cc, )(\se \ ~J do. 10 11 " 41 D. oD
AS50C io~+e (0 51, /b :11 [P(o,lIDO, tv
Total this page d-3 1'3 ( j!Zz1 ljq"l. DO
Grand Total 2~ /) 13/ $/2ZCJ, '119. DO,- : II It r ,f _.- "Name of person who prepared this r~11 ~ J\ ,1)
Preparer's Signature: "Title:'f?Ir-1 ne r () Phone #: 80';;' t../O'f - 91(p(y
Date Prepared: 5 /20/ /1:> .
![Page 40: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/40.jpg)
![Page 41: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/41.jpg)
XXXX3320211
![Page 42: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/42.jpg)
XXXX3320211
![Page 43: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/43.jpg)
XXXX3320211
![Page 44: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/44.jpg)
![Page 45: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/45.jpg)
![Page 46: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/46.jpg)
![Page 47: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/47.jpg)
FORM B OSC Use Only:Reporting Code:Category Code:
State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2015 to March 31, 2016
Contracting State Agency Name: SUNY Upstate Medical UniversityContract Number: T550086Contract Term: 1/7/2013 to 6/30/2017Contractor Name: Fisher Associates, P.E., L.S., L.A., D.P.C.Contractor Address: 135 Calkins Road, Suite A, Rochester, NY 14623Description of Services Being Provided: Campus Site Improvements at Upstate Medical University
Agency Code:~~dOC),,\\
1
Scope of Contract (Choose one that best fits):Analysis 0 Evaluation 0 Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT Consulting 0Engineering ~ Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0
Employment Category Number of Employees Number of Hours WorkedAmount Payable Under
the Contract17-1012.00 - Landscape Architects 9 1454.75 $140,771.9617-2051.00 - Civil Engineers 9 222.00 $25,723.8017-2041.00 - Mechanical En!lineers 4 214.00 $26,035.0017-3022.00 - Civil Engineering Technicians 3 544.50 $35,470.0827-1024.00 - Graphic Desiqners 1 0.50 $20.7017-1011.00 - Architects, Except Landscape and Nav, 2 171.00 $20,690.2817-3011.01 - Architectural Drafters 4 414.25 $20,994.5811-9041.00 - Architectural & Enqineerinq Manaqers 1 36.00 $5,162.5817-3019.99 - Drafters, All Other 1 139.00 $9,015.5417-1022.00 - Surveyors 1 8.00 $945.9217-3031.00 - Surveyinq & Maooinq Technicians 1 13.00 $1,003.2317-3031.01 - Surveying Technicians 2 31.00 $1,821.60
Total this page 38 3248.00 $287,655.27Grand Total 38 3248.00 $287,655.27
Name of person who prepared this repon .Preparer's Signature: ci.~tctcJ<-Title: Billing Administrato;Date Prepared: 4/29/2016
Lynn M. Peck
Phone #: (585) 334-1310
(Use additional pages if necessary) Page 1 of 1
![Page 48: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/48.jpg)
FORMB OSC Use Only:
Reporting Code:
Cateaorv Code:
State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2015 to March 31, 2016
Contracting State Agency Name: SUNY-Upstate Medical University Agency Code:53~~\'Contract Number: T550121Contract Term: 09/08/2014 to 03/31/16Contractor Name: Razak Associates Architecture, Engineering & Land Surveying PLLCContractor Address: 2060 Fairport Nine Mile Point Road, Suite 300, Penfield, NY 14526Description of Services Being Provided: Professional Design Services for UH 2nd Fir Corridor Lockers
Scope of Contract (Choose one that best fits):Analysis D Evaluation D Research D Training DData Processing D Computer Programming D Other IT consulting DEngineering D Architect Services cgJ Surveying D Environmental Services DHealth Services D Mental Health Services DAccounting D Auditing D Paralegal D Legal D Other Consulting D
Employment Category Number of Employees Number of Hours WorkedAmount Payable Under
the Contract
17-1011.00 2 78.5 $16,035.2017-3011.01 2 335.75 $11,414.40
Total this paQe 414 $47,196.51
Grand Total 414 $47,196.51
Name of person who prep ed this report·Preparer's Signature:_~~~~~=,.ocP.~t..f!~~:::::::.. _Title: Business Finan ManagerDate Pre ared: 04/28/16Use additional pages if necessary) Page 1 of 1
![Page 49: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/49.jpg)
FORM B ···---·..--·-------~Iose Use Only:
Reporting Code:
LC~a~te==or~C=o=d=e _
State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2015 to March 31,2016
Contracting State Agency Name: SUNY-Upstate Medical University Agency Code:~~Contract Number: T550121Contract Term: 09/08/2014 to 03/31/2016Contractor Name: IPD: EngineeringContractor Address: One Webster's Landing, Syracuse, NY 13202Description of Services Being Provided: Engineering services ,
Scope of Contract (Choose one that best fits):Analysis 0 Evaluation 0 Research 0 Training 0Data Processing D Computer Programming D Other IT consulting DEngineering [g] Architect Services D Surveying D Environmental Services DHealth Services 0 Mental Health Services 0Accounting D Auditing 0 Paralegal 0 Legal 0 Other Consulting 0
Employment Category Number of Employees Number of Hours WorkedAmount Payable Under
the Contract
Designer 1 - Electrical 1 12 900.._ ..
Administrative 1 1 100- ...._._-_.__ .__ ...__ ._.._.__ .....•..• _.
..._ .. •..... -..... -~...- __ ..._.-
--_._ .._._._---_ ...__ .._ .._ .
_ ..._ ..._ .•.•.... _._--
-_ ....
............ _ ...._._ .... _ ...__ .._-_. __ ..__ ...._- _ •....._ .._ ...
Total this page 2 13 $1000
Grand Total 2 13 1000
.._ .._-_._. __ .._ ..•._.. ------------Name of person who preE~red this report:Prepare,r's Signature: (j])_o '" q.d IJJ.+tTitle: LOnw ller I
.Q.~!~~~2ar~_g~if_'-~_y_1~I"","(Cl~ _
Use additional pages if necessary)
Phone #: 015 .1~7/· So.3'js'-j
--.--.--- ...--------~Page of
![Page 50: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/50.jpg)
FORMB
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2015 to March 31, 2016
Contracting State Agency Name: SUNY Upstate Medical
Contract Number: T550138 Agency Business Unit: SN\i 0 ,Contract Term: 04/01/2015 to 03/31/2016 Agency Department 10: 33 ';;lO-;;l \ \Contractor Name: HOLT Architects, P.C.Contractor Address: 619 W State Street, Ithaca NY14850Description of Services Being Provided: Architectural and Consultant Design Services
Scope of Contract (Choose one that best fits):
D Analysis DEvaluation D Research D Training
D Data Processing D Computer Programming DOther IT consulting
D Engineering [gI Architect Services D Surveying D Environmental Services
D Health Services D Mental Health Services
D Accounting D Auditing D Paralegal D legal D Other Consulting
Employment Category Number of Number of Amount PayableEmployees Hours Worked Under the Contract
27-3042.00 1 62.25 $ 5,838.83
47-4011.00 1 7.50 809.89
17-3011.00 1 4.00 209.76
17-3011.01 1 7.50 379.20
17-1011.00 6 617.00 62,631.73
17-2071.00 2 250.50 41,154.82
17-2141.00 3 67.75 9,856.14
17-3011.00 1 92.75 5,840.04
17-3023.03 1 7.50 640.15
17-3027.00 3 425.00 47,350.51
17-2051.00 1 44.00 6,770.00
Total this page 21 1,585.75 $181,481.07
Grand Total
Name of person who prepared this report: Allison Short
Title: Business Manager /) C'\I IPreparer's Signature: ~ ~
Date Prepared: 5/9/2016(Use additional pages, if necessary)
Phone #: 607-273-7600
Page 1 of 2
![Page 51: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/51.jpg)
·FORM B
New York State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2015 to March 31, 2016
Contracting State Agency Name: SUNY Upstate Medical
Contract Number: T550138 Agency Business Unit: SN" 0 lContract Term: 04/01/2015 to 03/31/2016 Agency Department ID: '33~OO)\ \Contractor Name: HOLT Architects, P.C.Contractor Address: 619 W State Street, Ithaca NY14850Description of Services Being Provided: Architectural and Consultant Design Services
Scope of Contract (Choose one that best fits):
o Analysis DEvaluation o Research o Training
o Data Processing o Computer Programming DOther IT consulting
o Engineering [8J Architect Services o Surveying o Environmental Services
o Health Services o Mental Health Services
o Accounting o Auditing o Paralegal o legal o Other Consulting
Employment CategoryNumber of Number of Amount PayableEmployees Hours Worked Under the Contract
17-3025.00 2 103.00 $ 6,829.00
17-3029.99 1 19.50 1,582.00
43-6014.00 1 1.50 114.00
11-1011.00 1 2.50 200.20
11-2021.00 1 6.00 480.48
17-2051.00 1 .25 20.02
43-3021.00 1 .50 40.04
43-4171.00 1 .25 20.02
15-1199.09 1 23.00 3,427.00
11-9041.00 1 30.00 5,310.00
25-9011.00 2 121.50 11,433.00
Total this page 13 308.00 $ 29,455.76
Grand Total 34 1,893.75 $ 210,936.83
Name of person who prepared this report: Allison Short
Title: Business Manager
Preparer's Signature: ~ c/{~Date Prepared: 5/9/2016
(Use additional pages, if necessary)
Phone #: 607-273-7600
Page 2 of 2
![Page 52: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/52.jpg)
FORM B
New York State Consultant Services Contractor’s Annual Employment Report
Report Period: April 1, 2015 to March 31, 2016
Contracting State Agency Name: SUNY Upstate Medical Contract Number: T550138 Agency Business Unit: Contract Term: 04/01/2015 to 03/31/2016 Agency Department ID: 28110 Contractor Name: Convergent Technologies Design Group, Inc. Contractor Address: 4849 Middletown Dr. Lockport, NY 14094 Description of Services Being Provided: Telecom, AV, Security
Scope of Contract (Choose one that best fits): Analysis Evaluation Research Training
Data Processing Computer Programming Other IT consulting
Engineering Architect Services Surveying Environmental Services
Health Services Mental Health Services
Accounting Auditing Paralegal Legal Other Consulting
Employment Category Number of Employees
Number of Hours Worked
Amount Payable Under the Contract
Project Manager 1 23 3427 Principal 1 30 5310 AV 1 41.5 4233 Design 1 80 7200
Total this page 5 174.50 $ 20,169.00
Grand Total Name of person who prepared this report: Kimberly Castle Title: Bookkeeper Phone #: 410-532-2395
Preparer's Signature:
Date Prepared: 04/21/2016 (Use additional pages, if necessary) Page 1 of 1
3320211XXXXSNY01
![Page 53: Upstate Medical University - New York State Comptroller · FORM B OSC Use Only: Reporting Code: Category Code: State Consultant Services Contractor's Annual Employment Report Report](https://reader030.vdocuments.us/reader030/viewer/2022040608/5ec620f322cd172ddd1dce26/html5/thumbnails/53.jpg)
FORM B r osc Use Only:
I Reporting Code:
~o_~~_C_o_de_: "
State Consultant ServicesContractor's Annual Employment Report
Report Period: April 1, 2015 to March 31, 2016
Contracting State Agency N~~~: . Agency Code:
Contract Number: 45095Contract Term: / 1 toContractor Name: VDA (Van Deusen & Associates, Inc,)Contractor Address: 120 Eagle Rock Avenue, Suite 310, East Hanover, NJ 07936Description of Services Being Provided: Program study for the replacement of elevators 18, 19and 20 in Weiskotten Hall
- "_ ...•... ~,:-_, -
Scope of Contract (Choose one that best fits):Analysis 0 Evaluation (g] Research 0 Training 0Data Processing 0 Computer Programming 0 Other IT consulting 0Engineering 0 Architect Services 0 Surveying 0 Environmental Services 0Health Services 0 Mental Health Services 0Accounting 0 Auditing 0 Paralegal 0 Legal 0 Other Consulting 0
----Employment Catego~ Number of Employees Number of Hours Worked Amount Payable Under
the Contract11-9041-00 - Architectural and
~ineering Managers 1 12,50 2,404.33
Total this pa~e 1 0 $ 2,404.33Grand Total 1 12,50 2,404.33
Name of,person who prep~red thi~)epqt Cr~igPavlickPreparer S Signature: ( ...p' Ie n~(_J-----.- __Title: Billing Rep ~c. Phone #: 973-994-9220Date Pre ared: 4/28/2016Use additional pages if necessary) Page 1 of 1